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Soviet Union admits to abuses of psychiatry

Pyotr Grigorenko, one of the founders of the human rights movement in
the Soviet Union, has been officially declared sane by a special commission
of top-ranking psychiatrists – four years after his death.

Grigorenko was a general in the Red Army and was awarded the Order of
Lenin, the Soviet Union’s highest award. After the Second World War he was
head of research at the Frunze Military Academy in Moscow. He was committed
to mental hospitals twice, in the mid-1960s and the early 1970s.

The daily paper Izvestiya hailed the findings of the commission, led
by Modest Kabanov, director of the Bekhterev Psychoneurological Institute
in St Petersburg, as the first official acknowledgment of past abuses in
Soviet psychiatry.

Kabanov’s commission of psychiatrists, from all over the Soviet Union,
spent six months in St Petersburg reviewing the Grigorenko files. The ‘case
notes’ were enormous – 29 thick volumes of legal proceedings, video tapes
and photographs. They included materials submitted by American doctors who
examined Grigorenko after he was exiled to the US in 1976. The evidence
also included Grigorenko’s own writings in defence of fellow dissidents,
in particular the Crimean Tartars who were exiled by Stalin and whose cause
he had taken up.

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Human rights campaigners hope that the commission’s pronouncement that
Grigorenko was sane and his confinement in mental hospitals unjustified
is the first step in a programme of rehabilitations for the thousands who
suffered similar treatment.

In the Brezhnev era a new disease was described: ‘sluggish’ or ‘creeping’
schizophrenia, the only symptom of which was the expression of politically
unacceptable views. Dissidents were treated with massive doses of psychoactive
drugs, which produced agonising side effects.

According to one former detainee, Viktor Fainberg, confining political
activists in a mental hospital not only punished the offenders, but also
discredited their ideas in the eyes of the Soviet public which, by and large,
has a rather intolerant attitude to mental illness. Even in ‘mild’ cases
of dissent – for instance, criticising the lack of safety precautions in
the workplace – just placing the offender’s name on the psychiatric register
was enough to ensure years of discrimination in employment, housing and
the educational prospects of the offender’s children.

As the number of ‘political’ diagnoses increased during the mid-1960s,
so did the activities of the Soviet human rights campaigners in bringing
psychiatric abuse to the attention of the outside world. A group of nations
tried – and failed – to have the Soviet Union expelled from the World Psychiatric
Association in 1977. Six years later, as the WPA’s general assembly approached,
the Soviet All-Union Society of Neuropathologists and Psychiatrists expected
that this time the decision would go against it and resigned.

With the coming of glasnost, muted references to the political use of
psychiatry began to appear in the Soviet media. The press became more outspoken
as its confidence grew. Early in 1989, a small group of doctors formed the
Association of Independent Psychiatrists. The breakaway association announced
that it would apply to join the WPA at its forthcoming general assembly
in Athens.

The establishment psychiatrists also began to prepare for Athens. They
changed the name of their society, replacing ‘Neuropathologists’ with ‘Narcologists’.
New legislation was drafted to protect psychiatric patients. Many names
were removed from the psychiatric register, and a review of all ‘political’
diagnoses was promised.

In Athens, the WPA voted to readmit the All-Union Society of Narcologists
and Psychiatrists, but would review its membership in 1995. The new Association
of Independent Psychiatrists was admitted unconditionally at the same time.

But disturbing reports continued to reach the West about continuing
political diagnoses in outlying areas of the Soviet Union. And, although
psychiatric prison hospitals have been transferred from the jurisdiction
of the Ministry of Internal Affairs to the Ministry of Health, people responsible
for past abuses remain in place.

This year began with the appointment of a new director of the Serbskii
Institute of General and Forensic Psychiatry in Moscow, the home of the
‘creeping schizophrenia’ theory. The new director, Tatyana Dmitrieva, immediately
began a radical programme of reform, both within the institute and in forensic
psychiatry generally.

Many of her ideas, such as specialised training courses for forensic
psychiatry and independent review boards, had first been suggested by the
Association of Independent Psychiatrists, says Yurii Savanko, the association’s
president.

With Moscow still a stronghold of the old guard of Soviet psychiatrists,
Dmitrieva did not immediately dismiss the idea of ‘creeping schizophrenia’,
but declared that all such diagnoses needed to be carefully reviewed.

Outside Moscow, progress has been faster. The All-Union Society of Narcologists
and Psychiatrists seems to be disintegrating as fast as the Soviet Union.
And new psychiatric societies have sprung up in St Petersburg, in the Baltic
states and in Ukraine.